11680 SW NORTH DAKOTA STREET-2 1S viomva HIL3N MS 099 1
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11680 SW NORTH DAKOTA ST
CITY O F T I G A R D - MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#- MEC2005-003 54
DATE ISSUED: 6/17/2005
13125 SW Hall Blvd.,Tigard,OR 97223 5034394171 PARCEL: 1S134CA-34000
SITE ADDRESS: 11680 SW NORTH DAKOTA ST ZONING: R-4.5
SUBDIVISION: BURLWOOD NO. 2 LOT: 013 JURISDICTION: TIG
Project Description: Installation of A/C:unit.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES _ 0 3 HP: 1 ^ DOMES.INCIN:
3 - 15 HP: COMML.INCIN:
MAX INPUT: STU 15.30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30-50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP: CLO DRYERS:
FURY<100K BTU: _ AIR HANDLING UNITS
FURN>=100K BTU: <■10000 nfm: OTHER UNIT
> 10000 cfm: GAS OUTLETS:
Owner: FEES
YOUNG, DENNIS M+ TERY NORMAN Description Date Amount
11680 SW NORTH DAKOTA ---------
TIGAR.D, OR 97223 (MEC'H]Permit Fee 6/17/2001 $72.50
[TAX] 8%State Surcha 6/17/200! $5.80
Phone: -503-590-8057Total $78.30US-590-SUS7 _.-- —.
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY,OR 97045 REQUIRED ITEMS AND REPORTS
Phon,: --)3-5�7-2220
Reg M '-IC 72623
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Or9. Specialty Codes and all other
m applicable laws. All work will be done in accordance with approved plans. This permit will expire If work is not started within 180 days of
issuance,or If work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted In the Oregon
J Utility Notification Center, Those rules are set forth in OAR 952-001-0010 through OAR 952-001 0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503-246-6699 or 1 800-332-2344.
Issued By: ,� , Permittee Signature: r
Call 503-839-41A
75 by 7:00 a.m.for Inspections that business d
This permit card shall be kept In a conspicuous place on the job site until completion of the prolect.
Approved plans are required on the job site at the time of each Inspection.
Jun 14 05 10: 23p Tri County Temp 5035570919 P. 1
Mechanical Permit A DINU-114-n
City of Tigard v Received
1. - DAWAY:
3i2Z SW 1491,31%-d.,Tigard,OR 97223 Permit No.
Phone, 503.639.4171 Fax: 503 599 1960 Plan Review
inspection Line: 303,639 4175 D&WIly: Odor pmqt:
Internet WWW,C1 tilPArd.or.us
Date Wtd_yf9�ylustso set Pa—le I for
ON
Nctifled/M.thod
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SCREDULE -
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❑ IS-
T4,!" c0n3trUcd0U Addidon/alteration/replacement IIIi-I per tit fees'are Wsed-1T � lue ofam�
El Dmoliticrn Other Performed.Indicate the value(rounded to the ncaretl dollar)of all
4!. mechanical mat!71!L,�ul enIlabqtr.overhead,and profit.
'77-777777
value::
SVSWM MS.
I-and 2-family dwelling C] mmAccessory building
Auld-family ❑Master builder C3 Other: For sPecial irifim7nation use checklist
DescriptionQt Ea. Total
OB sft
Dk*AND LOCAIION�,�7 ling/coollng
He*
Job site address: 1 Aii conditioning or heat pump -
W M0 _Qoquires Sim pun ShowmalPlocetrient) 14,00
cirv/state-tZIP:
Furnace i001000 BTU(ducts/vents) 14.00
&1UMA I
Suite/bIr1Q./illit.no.: Project name: —Fumace 100,000+BTLI(ductst�) 179011
On$beat plimr; 1400
Cross sirs t/directions to job site:
I Duct work 14,()0
— 4
liveronic hot waters .tern I 00
R;&idcntW boiler�(radiator or
-hydronic) 14.00
Unit heaters(fuel-type,not electnc),
in-wall.in-duct,Suspended,etc. 0.00
Subdivision: Lot no.: Flue/vent for r.y of above 10.00
Other Tax trulpiparcel no.: 10.00
Other fuslappliances
Water heater
1 10.00
CMS fireplace 10.00
Flue vent for water heater or gas
fireplace--- 11100
LX9*_1S_(lP_U) _ 10.00
_A224V melict Stolle 10.00
Wood tis.col,ce/insert 10-00
Othrr: 10.00
10.00
-TENAnit _gNmrig)l.nertfluttvent
Name:
Lw�- Inio yowtia Environmental exhaust end ventilation
.Address: Range ho(Wother kitchen
MM —_ .
- equipment _ 10.00 1
I city�-Stalezlp: Clothes dryer exhaust 10-00
Phone: Fax: Single-duct exhaust()10;�irlll
-toilet corripartrinents,utility ro�;.) 6.8
[3 WNU Attic/crawfspace fins 10.00
Business name: Other- 10.00
Contact name: {I{--UA piping
$5.40 for first four-31.00 for each additional
IL Address: I-3`W Ladhil Futnace,etc.
10 (�Vol-11
Gua hat u
CityiStair-IZIP: 6 in C Itz- Wit Vsus pendedlunit heateir
Phone:(T3) 557=M9 Fix: 7-Cq Water heater
E-mail: F1 I
_J
Barbecue
ur BusinCSS tame: Tri A T?f1W_MtTtM)
Clothes dryer(l:ag)W
.J Address: r", I a1613 P 'Cr
si,
Ciy.State/%Mn. -1r' k
_ ) .
Subtotal
Phone(r r--( LAI-.,-.-. Pe .
Plan review(25%of peffrdt fee) I
CCB lit.: 7
State surchanize 180%or Permit fee)
TOTAL PERMIT F -r-A
NuLlir-rized signarwe: 71e /7- dVC-y rmtt: I
De PD M pt K4tbin
days after It bac been accepted as complete.
Pn,it name: Nur v 4111564 Fee metbodology wt by Tri-County Building Industry go-ace Board
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CITY OF TIGARD
BUILDING DIVISION PERMIT M: MEC2006.00364
13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: 6117/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 All k
INSPECTION WORKSHEET FOR DATE: 7/512005 TIME: 7:12AM PAGE: 13
SITE ADDRESS: 116M SW NORTH DAKOTA ST CLASS OF WORK:
SUBDIVISION: BURLWOOD NO 2 LOT#: 013 TYPE OF USE:
PROJECT NAME: YOUNG
DESCRIPTION: Installatinn of A/C unit.
OWNER: YOUNG, DENNIS M +TERY NORMAN, PHONE#: 6 3-MB M7
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503-567.2220
Inspection Request Scheduled For: Date: 7/512006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 01074501 503557-2200 N
Corre /Comments/Instructions:
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SS/ PARTIAL .APPROVAL ❑ CANCEL ❑ NO ACCESS
[] FAIL ALL FOR INSPEG'i ION ❑ ADDITIONAL FEES ASSESSED
Inspector: __� Date: —Z—!;':-_4 Phone #: (503) ?IS-